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HomeMy WebLinkAboutInsurance Certificate: Louie's Bar & Grill LLC j .AEERv,-• • . . CERTIFICATE-OF:LIABILITY INSURANCE:::":_ MMIDDIYYYY) . 0 20 2018 • ••••THIS'CERTIFICATE.IS ISSUED'AS•A"MATTER OF INFORMATION ONLY,AND•CONFERS,NO"RIGHTS UPON.THE CERTIFICATE.HOLDER:.THIS.. :: " CERTIFICATE'DOES:NOT AFFIRMATIVELY.OR.NEGATIVELY.AMEND,.•EXTEND.OR.ALTER:THE:COVERAGE AFFORDED BY THE:POLICIES-" • . . '. ' :•. BELOW: THIS CERTIFICATE OF INSURANCE'•DOES-.NOT CONSTITUTE'A CONTRACT BETWEEN THE:ISSUING'INSURER(S);.AUTHORIZED. : ' • - REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.: :"- - - :• : ,. IMPORTANT: :If the'certificate holder-is.an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL,INSURED.provisions or be endorsed::.' - . If•SUBROGATION IS WAIVED;subject to.the terms and.conditions'of the-policy,'certain.policies may require:an endorsement."A statement:on this:certificate does not confer rights to the certificate'holderin lieu.of such'endorsement(s).: ' -. "• ' •• PRODUCER' ' • Sart: Insurance'Agency -'Medford. P.HONECTICriatia "Wick FAX . ' ' •P0'Box.1240.' . • . . • .' ' . ' (NC:No.lin:• (541).' 779-4232.' • (A1C;No): • Grants:.Pass' OR 97528 ' • E-MAIL • ' • . : . � ' _ ADDRESS• • ' •' INSURER{S)AFFORDING COVERAGE.' NAIC# INSURER'A:SAIF•Corporatioa' 3619.6 INSURED• • 43494. (541)..30Y 4068 . 'INSURERS:Ameiican Hallmark Insurance.Co" Louie'a. Bar & Grill LLC" :. 41'N'Main-St. INSURER'D:. . Ashland'OR 97520 . ': " _ SURER E : . -" COVERAGES . - : • -: • •:' ...CERTIFICATE NUMBER:Cert-ID 8233"- " " ,. • . • • `• -..REVISION.NUMBERt • : ...• : --• •.' • -- -' : ': THIS.IS TO CERTIFY-THAT-THE POLICIES OF-INSURANCE'LISTED•BELOW'HAVE BEEN ISSUED'TO'THE INSURED-NAMED-ABOVEFOR THE POLICY PERIOD'.. : : •- INDICATED:.NOTWITHSTANDING ANY REQUIREMENT,"TERM OR CONDITION OF'ANY.CONTRACT'OR OTHER'D.000MENT WITH..RESPECT TO WHICH THIS • • CERTIFICATE.MAY BE. ISSUED.OR"MAY.PERTAIN,.THE INSURANCE AFFORDED.BY.THE'POLICIES DESCRIBED HEREIN-IS."SUBJECT TO'ALL THE TERMS, - ' . ' EXCLUSIONS'AND CONDITIONSOF SUCH POLICIES.-LIMITS SHOWN MAY HAVE•BEEN'REDUCED BYPAID.CLAIMS.-' ' - '" ' • .••- • ' ' INSR •• -- •.•PE OF INSURANCE ADDL SUER . . • " - . • POLICY EFF' POLICY EXP. LIMITS • • . . •' LTR • " " INSD WVD . ' -POLICY NUMBER-' . • (MMIDDIYYYY) (MMIDDIYYYY)' . •- . B' .X OMMERCIAL GENERAL'LIABILITY,. .' FJICHOCCURRENCE $_.' •1;000.,0'00' •• ' DAMAGE TO RENTED CLAIMS-MADE X' .00CUR .' •Y ' ' '44PB500406' ' . 09/.01/2018 09/01/2019 'PREMISES(Ea occurrence) • $ .• 100,000 n .MED • .EXP'(Anyo eperson)' $ • '- 5,000 ' ' "• 'GEN'LAGGREGATELIMIT APPLIESPER: - '"• ' ' - . GENERAL AGGREEGATE'Y• • $ .' ••2,000,000 , • ' x' POLICY PRO- LOC• . ' • • • • " • • PRODUCTS-.COMP/OPAGG '$ ' ' 2,'000,000 - 1:000.,0'00'. .AUTOMOBILE LIABILITY. ': _ '$ -" COMBINED SINGLE LIMIT.• • • " '(Ea accident) ANY AUTO. ", BODILY'INJURY(Per person) .$': .. OWNED. SCHEDULED , . .. AUTOS ONLY.• _ AUTOS _ BODILY INJURY(Per accident) $ HIRED- " NON-OWNED - PROPERTY DAMAGE' AUTOS ONLY AUTOS ONLY (Peraccident) : .. UMBRELLALIAB .. .,•OCCUR : EACH OCCURRENCE $: • - • EXCESS LIAR. .. CLAIMS-MADE . AGGREGATE $ •.: DED RETENTION$ $ WORKERS COMPENSATION " '' ' ' " .. •" ' • 'A• AND EMPLOYERS'LIABILITY 7 YN.• ' • 66283. ' ,• 01/01/2018:01/07./2019 X STATUTE" ERH • • • n ANYPROPRIETOR/PARTNER/EXECUTIVE. : • 7• ' EL EACH AC (DENT. • • ' OFFICER/MEMBEREXCLUDEDT .. ' NIA ;. '' $ • 500,000 (Mandatory - " ' E.L.DISEASE-EA EMPLOYEE.$ • 500,000 " • ' If yes,describe.under. .. ' .-- - DESCRIPTION OF OPERATIONS below •' • " .• " . -•-- • " EL DISEASE-'POLICY LIMIT 5.. _ - 5004000 " . . ;" . ." . . - " . DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES'(ACORD 101,Additional Remarks Schedule,may be attaehed If mere space Is required)" . • '' . -: : • :. ' :Cityof•Ashland.is an'Additional•Insured,per:the•attachedCBP047' 03/0e. p3/0 .in. ts • the'ouide.':. , '. ' - . seating'area: . , • .. ' ' CERTIFICATE HOLDER': CANCELLATION . SH.OULD'ANY OF.THE ABOVE DESCRIBED POLICIES`BE CANCELLED;BEFORE `, ' . . - " . • • • - •' THE EXPIRATION' DATE .THEREOF,•'NOTICE 'WILL'BE•'DELNERED''IN" . : - • • • City of Ashland •' ' ACCORDANCE WITH THE POL•ICY.PROVISIONS. 20.E'Main Street " OR _ UTH A l)REPRE§ENTATIVE" Aehland OR.97520 :. :. ' : .. .. . - ': - . .. • ' -•©"1988=2015 ACORD-CORPORATION..All rights reserved ". ACORD 25"(2016/03)_ . "-: " -- ' The ACORD name and logo are registered marks of ACORD -. ---- • : • -. : _. -' .. : •Page 1' of"1: .� • ''